Hubris

“I think he’s just anxious about it,” the medical student told me a few sentences into the presentation.  His patient had had a spontaneous pneumothorax, a leak of air between the lung and chest wall, a few years ago, and now he had some uncomfortable feeling and was worried about a recurrence.  I hadn’t heard the full story … Continue reading

Slow Medicine

Time heals all wounds, they say, or, in medicine, if not all, then many.  But with our improved efficiency and throughput of patients, we fail to allow this most magical treatment to work.  The pace and intensity of medicine has increased exponentially over the past several decades.  We see more doctors, have more procedures, take … Continue reading

Need Oxygen to Smoke

Need Oxygen to Smoke? my editorial in the Salt Lake Tribune on the difficulty of tobacco cessation.  What do you think about the policy at the Cleveland Clinic and other large employers that refuse to hire smokers? Below are my links that were embedded in editorial, but for some reason SLC trib removes them. …Even … Continue reading

Denial and the Imponderable Differences

David Foster Wallace “Infinite Jest” Page 604 …people of a certain age and level of like life-experience believe they’re immortal: …they deep-down believe they’re exempt from the laws of physics … And they’re constitutionally unable to learn from anybody else’s experience: if some jaywalking B.U. student does get splattered on Comm. or some House resident … Continue reading

Can I Become A Doctor Online?

The cost of medical care and the cost of education in general is sky rocketing. But it is much worse to be at the nexus of these two endeavors – Medical Education. The current path to becoming a doctor in the US involves four years of university followed by four years of medical school. Each … Continue reading

Customer Satisfaction

I recently changed my children’s dentist because his office was too nice.  As with their doctor, it is impossible for a lay person to have any idea whether their dentist is clinically competent or good.  Most of us choose our dentists the same way we choose physicians – by personal recommendations from people we know, … Continue reading

Genetic Testing

“If you want CVS, you’ll have to decide within the next three days,” the genetic counselor told us. My husband and I were sitting in the upscale office of the maternal fetal medicine (MFM) practice in downtown San Francisco. Our obstetrician had referred us here for genetic testing of our twins in addition to the … Continue reading

Post Hoc, Ergo Propter Hoc

We understand very little about the human body. Sometimes I think that the more we learn, the more we learn how much we don’t know. Occasionally, our patients show us. Take Jim*, for example. He came to me complaining of wheezing and shortness of breath. He had been newly diagnosed and treated for asthma over … Continue reading

Continuity of Care

“I would want you as my doctor.  I just wouldn’t want your life,” I said to the thoracic surgeon.  It was after midnight and we were standing in the intensive care unit.  I, having urgently intubated a critically ill patient; he, having finished a surgery on a patient we shared.  This particular patient had had a lung … Continue reading

Anxiety

Anxiety ranks among my least favorite diagnoses.  In medicine, we have a long history of blaming a variety of diseases on anxiety.  Even in the recent past we attributed gastric ulcers to stress until it was proven that a bacteria that lives in the gut is responsible.  Indeed, who would have thought:  a bacteria living … Continue reading